1. Field of the Invention
The present invention relates generally to a device and method for placing a tube for tube feeding a patient. Specifically, the invention relates to a novel tube feeding device that separates and thus allows insertion and removal by an advantageous combination of techniques.
2. Discussion of Related Art
Tube feeding is necessary when a patient requires long-term feeding assistance. In tube feeding placements, an incision is made through a patient's abdominal wall and stomach and a catheter is inserted therein. The patient is then fed a nutrient solution directly through the catheter into the stomach. However, methods for placing the catheter vary, as do the catheter specifications and techniques for removing the catheters.
Current methods for insertion of a percutaneously placed catheter include a pull-through technique, a push technique, and an introducer technique. Both the pull-through and the push technique require a catheter to be passed through the mouth, down the esophagus, through the stomach, and out the incision. The passage of the catheter in this manner can cause damage to the back of the throat and esophagus, especially when the catheter includes an apparatus at its leading and trailing ends for use in feeding and in holding the catheter in place. In addition, when a retention apparatus is included, removal of the device must usually be accomplished with a second endoscopy. Both of these disadvantages are particularly problematic in neonates, who have smaller less well-developed passageways and are thus more prone to injury from tube placement. Moreover, neonates often require potentially risky general anesthetic for each endoscopy.
Another method of inserting a catheter, the introducer technique, avoids these problems by pushing the catheter directly into the patient's incision. A dilating sheath must first be inserted though the incision, then the catheter is inserted by pushing it through the sheath. The sheath is then removed and the catheter is fixed in place. In this technique, endoscopy is not required for removal since an inflatable (Foley) bolster is used. It can be deflated and the entire catheter removed with a gentle pull. However, the incision made in an introduction insertion must be larger than in the other techniques, and the larger incision in the abdominal wall and stomach creates a higher likelihood of leaking around the area of the catheter.
It would therefore be desirable to have a device which would enable the passage of a catheter without damaging the back of the patient's mouth and esophagus, would not require an unacceptably large incision in the patient's abdominal wall, and would not require repeat endoscopy for removal.